HomeMy WebLinkAboutR 2019-159 Animal Svc - Amanda Chapman veterinary services DocuSign Envelope ID: DCBF9B19-4560-44DC-A9D0-71 F645AC8BDC
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ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Amanda Chapman, DVM PartyNendor Contact Person: Amanda Chapman, DVM Contact
Phone: 920-246-2592 Party/Vendor Address: 104 Mullin Court City Chapel Hill State:NC Zip: 27514 Department:
Amimal Services Amount: 999.99 Purpose: Veterinary Services Budget Code(s): 10215020 629004 Vendor#
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New❑ Renewal
® Amendment ❑ Effective Date July 1.2018 Approved by Board Yes[]No❑ Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
OocuSigned by:
Department Director's Signature C 6
� o{�o Date: 3/8/2019
C9B58115B7D6482...
Agreements for emergency services u, ,u,an at aim,juuject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed: rabies clinics held earlier in fiscal year
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Information Technoloeies g
Y
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficien [QuSlgned by: ards,specifications,and requirements:
dUSa (,bVln.f 6
Office of the Risk Management Oftic 7FDCF917e800498. Date; 3/8/2019
Financial Services
This instrument has been pre-audited i oocusigned by: the Local Government Budget and Fiscal Control Act;
4 . 3/11/2019
Office of the Chief Financial Office Date:
704E51S1ACC1409.
Leval Services
This agreement is approved as T-1
ooeusigned by:
�, kavit, S� 3/11/2019
Office of the County Attorne079A4D525COF4FB. Date.
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll[7a orangecountyne,gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
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Revised 12/18 4